The Oaks Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question inadequate. At this assessment the rating has changed to good.

The service was previously in breach of the legal regulation in relation to safe care and treatment, safeguarding, the environment and staffing. Improvements were found at this assessment and the service was no longer in breach of these regulations.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had developed a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Since the previous assessment additional processes were followed to ensure all accidents, incidents, safeguarding concerns and complaints were appropriately investigated and actioned. Details about actions taken and if any referrals to other agencies were recorded. Information was now shared with staff to prevent reoccurrence and support learning. Lessons learned information was shared with staff either through supervision, staff meetings or memos.

We reviewed a recent incident where a refresher lessons learned session was held with staff to share information and refresh their knowledge. A staff member told us, “We have group supervisions for ‘lessons learned’. Where appropriate staff are given a copy of the relevant policy.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The management team had worked hard to ensure safe systems of care were established including working with other professionals. We saw evidence of referrals to partner agencies, and any records of these visits were recorded. The GP visited weekly and reviewed people’s clinical needs. Care records were kept up to date to enable the service to provide an accurate summary of people’s needs and risks should they need to move between services.

We reviewed a recent admission to the home where very quickly referrals were made to other professionals to gain support with the person’s current needs. The staff had also identified concerns about this person’s previous placement and escalated these concerns to all relevant agencies promptly.

A person told us, “Doctor is very good, optician came yesterday but I don’t need an eye appointment at the moment.” This person also told us they had a reminder from the dentist and the chiropodist visited them regularly.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

The service used a structured and comprehensive incident, accident and falls report tool to monitor, audit, and analyse all reported events across the service. This tool supported compliance with regulatory requirements, including notifications to the Care Quality Commission (CQC), and safeguarding authorities, where applicable.

Staff had completed training and felt able to report recognise and escalate any concerns of abuse. A staff member told us, “I would go to the nurse or manager to report this. I would go to the local authority if they did nothing about it.” Another staff member said, “I would document and inform the manager. If I see anything I would speak to the nurse. They always follow everything up and give me the outcome.”

People and relatives told us they or their family member felt safe with staff. A person told us, “I do feel safe, it is good here, all have been very helpful.” Another person said, “I feel safe, it is the staff’s confidence, they do what it says on the label, I don’t feel under threat.”

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Care plans including risk were reviewed monthly. People were encouraged to discuss their care needs with the staff to ensure it met their requirements. Relatives were invited to attend either in person or over the telephone to discuss their relative’s care needs if appropriate.

Comprehensive oversight was now in place to identify, monitor and mitigate all risks related to people’s care. Controls in place were reviewed regularly. Oversight of wound care was now robust and included all information necessary.

People were able to move freely around the service if able and we observed safe moving and handling throughout our visit. Staff told us they had access to risks around people’s care and were updated by senior staff regularly. When we asked staff about the risks we had identified within people’s care plans, they demonstrated a good knowledge of their risks and needs. A staff member told us, “[Person] is cared for in bed, we do their personal care. We assist [person] to eat. We ask them what they want, and I know what specific food and fluid they have.” (Staff member was able to quote the specific food level the person had confidently).

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The provider had undertaken some improvements to the environment both inside and out. Equipment was available to assist people to use communal spaces if they chose this. Whilst we saw some people chose to remain in their room or bed these choices were now recorded within their care records and known by staff. There were appropriate dining tables now available for people to use, and additional plans were proposed to extend the lounge and dining place in Emerald. However, staff told us people had access to other communal spaces within the service and gave us examples of people using these. There had also been a considerable amount of work to improve the outside areas of the service and make them more accessible to people.

There were areas of corridor flooring with some damage, however, the manager confirmed this was booked for replacement in stages to minimise disruption.

Systems and equipment were maintained and serviced to make sure they remained in good working order and were safe to use. A staff member responsible for the maintenance of equipment and the environment told us, “When the manager did the action plan for the CQC it was the first time I have been asked to be involved.” Personal Emergency Evacuation Plans (PEEP) were now held within the service's emergency grab bag. The purpose of a PEEP is to give staff and emergency service personnel critical information on the evacuation needs of each person in the event of a fire emergency. This meant information was now easily accessible in the event of an emergency for staff or emergency service personnel.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

People and relatives told us staff now responded appropriately when they called for assistance. A person told us, “Carers are very good, buzz and they come pretty quick.” Another person said, “The buzzer I have always got it, I have it under my pillow at night, it is not a long wait when I buzz.” A relative added, “They are now coming quicker than they used to.”

The service now had oversight of call bell times which indicated when people called and how long staff took to respond. We reviewed this and could not find any call time responses which were concerning.

Staff told us there were enough staff to meet people’s preferences and needs. A staff member told us, “Only 14 residents on this section so more than enough staff. We also have enough chairs, and we have people who get up every day if they choose this.” Another staff member said, “There is always enough staff and that is the same at evening and weekends.” Senior staff had a good understanding of how people’s dependency levels informed staffing capacity and the appropriate skill mix."

People also confirmed they were happier with the support they received with personal care. A person said, “I need help showering, I have no problems have a shower every day, I am not rushed.”

Staff told us they were happy with the training and had recently completed some face-to-face training. A staff member told us, “We update this every year, but we can update this at any time We do practical moving and handling and first aid. The training is good. “The manager and deputy kept an overview of staff training and the current percentages of compliance for each staff member and the service as a whole. The manager also used staff meetings as an opportunity to update staff in various subjects.

Staff received supervision and appraisal and were happy with the support they received. A staff member told us, “I have supervision/appraisal and staff meetings. I do feel supported very much.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

We observed the environment to be clean throughout the assessment. The service employed a head of housekeeping who worked closely with the domestic staff undertaking observations and audits to ensure cleanliness at the home. They told us, “I enjoy making sure everything is organised, I know the other housekeepers are comfortable in their role and spending time with residents. I do spot checks throughout the day.”

Regular infection control checks and audits were completed, and we saw when a concern was identified, it was actioned quickly. All staff received infection prevention and control training as part of their induction and through ongoing refresher sessions. Training included hand hygiene, PPE use, waste management, and recognising signs of infection.

The service had recently been awarded a five-star rating for the kitchen following a visit from an environmental health officer.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.
We checked the medicine stock at random, and they tallied with the medicine administration charts which demonstrated people received their medication as prescribed.
We found protocols in place to guide staff when to administer ‘when required’ medicines. However, we did identify a couple of protocols for a specific drug were not available, but these were provided to us following the assessment.

Medicine care plans were in place which gave detail about the medicines people were being administered. A person told us, “I have my tablets first thing, 6 I think, they [staff] stay with me. I have no concerns, I can talk to the nurse, they are alright.”